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News | 31/10/2023
PUBLICATION IN THE JOURNAL THE LANCET INFECTIOUS DISEASES

New tool facilitates tuberculosis diagnosis in children

An LMU-led international research consortium has tested a tool that could significantly improve the diagnosis of tuberculosis in children using a blood sample taken from the fingertip.
Around 240,000 children worldwide die of tuberculosis every year. This disease is one of the ten most common causes of death in children under the age of five. One of the main reasons is that, particularly in the disease is often not diagnosed correctly or in good time, especially in diagnosed in time. An important step forward can now be a new diagnostic tool developed by an international research research consortium led by LMU physicians Laura Olbrich and Norbert Heinrich from the Tropical Institute of the LMU Hospital as part of a large-scale in five countries as part of a large-scale study. The authors report on their results report the authors in the journal The Lancet Infectious Diseases.
© LMU/Laura Olbrich, Craig Dalgarno
Labormitarbeiterin Deepa vom Christian Medical College (Vellore, Indien) präsentiert die untersuchte Testkartusche
Tuberculosis tests commonly used to date are generally based on microbial detection in sputum, i.e. secretions from the deep respiratory tract. These samples are difficult to obtain in children, and paediatric tuberculosis is often characterized by a low bacterial load and non-specific symptoms. "That's why we absolutely need new tests," says Olbrich.

Simple and quick blood test

The new tool that the researchers have now tested is based on the activity of three specific genes that can be analyzed in capillary blood. An innovative, semi-automated system is used to determine a so-called transcriptional signature of these genes. This transcription signature can help to diagnose tuberculosis. The test has the advantage that the blood sample can simply be taken from the fingertip and the result can be determined very quickly: "The result is available in just over an hour. With most other tests, you first have to send the samples to other laboratories," says Olbrich.

The researchers tested the new tool as part of the extensive RaPaed TB tuberculosis study led by Heinrich together with cooperation partners in South Africa, Mozambique, Tanzania, Malawi and India. A total of 975 children under the age of 15 who were suspected of having tuberculosis were included in the study. To determine the accuracy of the test, the researchers also examined the children's tuberculosis status using a standardized reference test based on the examination of sputum and cultivation of the bacteria.

"The results were encouraging," says Olbrich. "The test identified almost 60 percent of children with tuberculosis compared to cultural detection, with a 90 percent specificity. This makes the new test comparable to or better than all other tests that work with biomarkers. The bacterial culture is always the reference because it provides the most stable results. But it takes up to eight weeks and is usually not available locally." Since the reference signature was largely determined on adults, the researchers also assume that the test results can be further improved if the signature used for the test is adapted for children.


Original announcement: LMU, 31.10.2023

Further information

Publication

Partners of the RaPaed-TB consortium

  • Department of Infectious Diseases and Tropical Medicine, LMU Klinikum München
  • Center for International Health LMU (CIHLMU )
  • Center for Clinical Microbiology, University College of London, UK
  • Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK
  • Department of Clinical Microbiology, Christian Medical College (CMC), Vellore, India
  • Department of Paediatrics and Child Health, SA-MRC Unit on Child and Adolescent Health,
  • Department of Paediatrics, University of Melbourne and Murdoch Children's Research Institute, Melbourne, VIC, Australia
  • German Center for Infection Research (DZIF), Munich site
  • Research Center Borstel (FZB), Borstel
  • Foundation for Innovative New Diagnostics (FIND), Geneva, Switzerland
  • Fraunhofer Institute for Translational Medicine and Pharmacology ITMP - Immunology, Infection and Pandemic Research IIP, Penzberg/Munich, Germany
  • Helse Nord Tuberculosis Initiative, Department of Pathology, Kamuzu University of Health Sciences, Blantyre, Malawi
  • Immunology Research Group, Division of Molecular Biology & Human Genetics, Faculty of Medicine and Health Sciences; Stellenbosch University, Stellenbosch, South Africa
  • Instituto Nacional de Saúde (INS), Marracuene, Mozambique
  • Mbeya Medical Research Center, National Institute for Medical Research (MMRC), Mbeya, Tanzania
  • Oxford Vaccine Group, Department of Paediatrics and the NIHR Oxford Biomedical Research Centre, University of Oxford, UK
  • Pediatric Infectious Diseases, Department of Pediatrics, Christian Medical College, Vellore, India
  • Research Center for Environmental Health (HMGU), Neuherberg, Germany
  • Global Health Unit, Helmholtz Zentrum München
  • University of Cape Town Lung Institute (UCTLI), Cape Town, South Africa

Promotion

This study was funded by the European and Developing Countries Clinical Trials Partnership (EDCTP2 program, supported by the EU; RIA2016MC-1623). Additional funding was provided by the German Center for Infection Research (DZIF) and Beckman Coulter. Cepheid provided test kits and GeneXpert platforms free of charge to the RaPaed-TB consortium.

Dr. med. Laura Olbrich

Abteilung für Infektions- und Tropenmedizin

Forschungsgruppe Neue TB-Diagnostika